Health & Medical Health & Medical Insurance

How to Understand a Health Insurance Policy

    Types

    • To understand your policy, you first need to know the type of insurance you carry. According to the NetQuote website, health insurance types include basic coverage, which pays for things such as doctor visits, and major medical, which pays for major expenses such as hospital stays. If your plan is a managed care plan such as an HMO or PPO, you may be restricted to seeing a specific network of health care providers.

    Basic Terms

    • Some basic health insurance terms to become familiar with are deductibles, which is the amount you pay before coverage goes into effect; coinsurance, which is the amount of the cost you share with your insurance company; and copay, which is a fixed amount you pay for items such as doctor visits. These can vary greatly depending on the type of policy you carry.

    Covered Occurrences

    • Your policy will spell out what is and is not covered. Typical items include what preexisting conditions are covered, the dollar limit for each covered occurrence and whether additional coverage for things such as dental and vision care are included. It will also contain a list of excluded items that will not be covered under any circumstances.

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